Osteoarthrosis arthroscopy, treatment | artroskopia - artromedical - konrad malinowski

Osteoarthrosis - Treatment
There are multiple ways of treating osteoarthrosis. It's the most important,
however, for the treatment to be complex and include:
non pharmacological treatment (healthy lifestyle, nutrition, dieting, wearinginsertions in shoes, doing exercises that increase the mass of muscles),pharmacological treatment (taking prescribed drugs),rehabiliation (kinesiotherapy and physiotherapy). TREATMENT AND REHABILITATION
In a case where the cause is unknown, the treatment aims at reducing symptomsand modifying the course of the disease. When the cause is known however, thetreatment concentrates on the cause, as well as the symptoms and the course of thedisease. Every patient is treated according to the kind and progress of the disease. Conservative treatment includes pharmacological means and physiotherapy. It aimsat reducing the symptoms and introducing active exercises.
Patients with osteoarthrosis of hips and knees should avoid sitting at soft, deeparmchairs. They should sit on simple, hard chairs, sleep on hard beds, rememberabout correct posture, remain physically active and decrease stress onto the joint byhaving some rest and later by using a cane or crutches. Exercises that have been well chosen, that aim to keep proper muscle strength andelasticity, to keep maximum painless mobility and to avoid muscle contraction,especially those that consist in non weigth bearing, help to decelerate the diseasecourse. We also should remember to rest during a day, so that the joints aren'toverburdened and over exploited. Immobilization, even if short-term, may causeexacerbation of the disease and complete arthrodesis in a restricted posture.
Patients should reduce body weight, avoid changeless overburdening (especially inextreme positions of the joint, be it extension or flexion).
Physiotherapeutic procedures used in osteoarthrosis: electrotherapy: ionophoresis, interference currents, TENS,if pain is caused by changes in the connective tissue in young patients, it'srecommended at the beginning to introduce treatment that improves localblood circulation; the treatment prepairs the patient for exercises. It includes:hot baths, peat poultices, massages, solux, warm gel wraps. If, however, thedisease is far advanced, patients must avoid the following: hot baths, peatand paraffin and Fango poultices and DKF. They might worsen the coexistingosteoporothic changes.
kriotherapy brings anti swelling and anti infalmmatory effects,laser therapy and magnectic field. PHARMACOLOGICAL TREATMENT
In the case of osteoarthrosis, one of the most bothersome symptoms is pain, felt tel: +48 509 513 810 | e-mail: [email protected] | www.artromedical.pl Osteoarthrosis - Treatment
differently by every patient. We use the following drugs to fight the pain and reducethe inflammation: 1) Non steroid anti inflammatory drugs – they are analgesic, anti inflammatory andantipyretic. This group includes, among others: paracetamol, diclofenac, ibuprofen,acetylsalicylic acid, indomethacin, ketoprofen, naproxene, piroxicam and sulindac.
They may be administered orally, rectally or locally onto skin (creams, ointments orgels). If the pain isn't severe, it's enough to use a cream, gel or an ointment. If thesymptoms are more severe, it's better to use drugs that are administered eitherorally or rectally. 2) Glucocorticoids – administered directly into the joint or into the pain area, notmore than 1-3 a year, since greater quantity of the injected substance may lead toquicker and more extensive joint damage. 3) Disease-modifying drugs – that is suflazaladine, D-pencillamine, gold preparations,immunosuppressing drugs, eg. methotrexat. Modifying, immunosuppressing orsteroid drugs are much stronger. They may, however, cause side effects, such as:nusea, headaches, vomitting, skin irritation with a rash, intestinal disorders and/ordiarrohea. 4) Myorelaxant drugs – many of them have a calming effect, wear off anxiety, eg.
tetrazepam or tolperisone. 5) Drugs improving blood circulation and the metabolism of tissues – they'readministered when we assume the blood vessels pathology to be a part ofosteoarthosis pathology. Arthrosis often coexists with varicose veins of lowerextremities. This group of drugs includes diosmine. 6) Medicines containing elements of articular cartilage – glucosamine, chondroitinsulfate, collagen, vitamin C. Theoretically, these drugs help to build in elements ofcartilage, which improve articular cartilage slide – they have a positive effect onpatients in early stages of the disease. These drugs are being widely tested in theUSA. 7) Hialuronic acid injections – various kinds of drugs, administered into the joint 1-3to 5 times in a week' intervals. They contain hialuronic acid which is a naturalingredient of the synovial fluid. They improve articular cartilage slide and tissuenutrition. They work as long as 6 months. 8) Homeopathic injections – they contain herbal extracts and extracts from animalplacenta. They stimulate healing and reduce the inflammation. 9) Injections of autologous growth factors – not popular in Poland, common in otherEuropean countries. They stimulate healing, reduce inflammation and increase thepotential of the cartilage to regenerate. SURGICAL TREATMENT
tel: +48 509 513 810 | e-mail: [email protected] | www.artromedical.pl Osteoarthrosis - Treatment
Should the conservative treatment be ineffective and the pain is nagging (the painbeing the primary indication for a surgery) or there're extensive joint damages, asurgical treatment can be a solution. Depending on the disease we perform: surgeries to remove tissues changed and damaged due to an inflammationand to reduce existing contactions (arthroscopies),surgeries to correct the placement of bones and joint surfaces (osteotomies)surgeries to replace joint surfaces (endoplasties) – cutting out damaged jointelements and replacing them with new metal or plastic parts,surgeries to fix the joint,corrective surgeries – if the joint damage is extensive, the course ofligaments and bone placement is surgically corrected, which improves thefunction of the limb. tel: +48 509 513 810 | e-mail: [email protected] | www.artromedical.pl

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